Do Ileostomies Affect Absorption of Fat-Soluble Vitamins?

Question in regards to ileostomy and fat-soluble gel cap vitamins like vitamin D: Does an ileostomy absorb them, or does the pill just come out in the ostomy bag? I've had time-released medications in the past, or any that are enteric-coated, and they just go right through and into the bag. Just curious if anyone here with an ileostomy takes or has taken fat-soluble gel capsules. Thanks, all.

I take vitamin D and it doesn't come out in my ostomy bag. It is not time released though. I have had pills come out in my ostomy bag before. The biggest one was when I took fish oil gel caps. Gel caps don't work well for me for any medication. My vitamin D is a capsule but not a gel cap. It absorbs fine. 

So is it powder in your capsules? 

I take a chewable D3/K2 supplement as well as chewable multi, B-complex and C.

I also take a vitamin D supplement, but it's a tablet, not a gel cap.  I do take a K2-D3 gel cap and it dissolves fine.  The only pill I take that would come out in my pouch, was a small magnesium tablet, so now I chew them instead, even though they are not 'chewable'.  I also take a rather large pill/tablet (glucosamine) which seems to dissolve just fine, so the size doesn't seem to be the issue.

Terry

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

Hi M,

It really depends on the construction of the gelcap. Regular hard gelatin caps dissolve in the stomach in about half an hour. Alginate-coated gelcaps dissolve at the end of the small bowel near the ileocecal valve, so if you're an ileostomate, this one may or may not end up undissolved in your bag. Your length of bowel remaining, whether your ileocecal valve is intact and working, and how much fat you consumed before you took the cap would all come into play. Enteric-coated caps are designed to dissolve higher up in the small bowel, but it depends on how much fat is in your stomach when you take it that determines where exactly it dissolves. And softgels are designed to dissolve in the stomach very quickly. So if you're seeing the caps in your bag (with or without their contents in them), you might want to contact the manufacturer and find out what kind of cap they're using...and then find a quicker releasing cap from another vendor. Personally, I take my Vit A and D sublingually, bypassing the whole digestive tract altogether.

;O)

I take vitamin D tablets and have never had a problem. To be honest, I've never had any type of tablets I've taken in over 30 years come out in my bag, but what's right for one is wrong for another. Just try them and see how it works for you.

Yes, it's a powder; it's a very small capsule. It always absorbs for me, though. I take it every day at noon with my lunch.

If you have an Ileostomy, you should avoid time release meds, as well as coated (enteric) tablets.  These restrictions should be put on your profile at your pharmacy.  Always double check. One time they gave me an enteric tablet and tried to tell me it wasn’t. (White tablet coated with red).  Fortunately, I knew better.   Please always advocate for yourself.  

I have no problem with gelcaps or Capsules. I purposely wear a clear bag so I can make sure none of those are in there.  We are each different, though, so be sure whatever you take is fully dissolved and not in your bag.

I've had problems with timed-release meds passing whole in the pouch. You could always poke holes in the gel caps with a safety pin so at least the vitamin can pass into your bloodstream. I do, however, use sublingual or quick dissolve meds when possible. My Vit D is a gummy.

I take vitamin D pills and have an ileostomy  My vitamin D levels are good so I assume they are being absorbed. I take a sublingual B complex to keep B levels up. That works too. 

I chew them so as to absorb it under my tongue.  Very palatable.  Same with fish oil capsules.

I take vitamin D as well. It is a round gel pill. I don't have any problems with it. The only one that came out not dissolved was one for my kidney stones. I take a lot of vitamins. I also take omega-3, which is kind of big, and it is a gel cap; again, no problem. Maybe I have a much slower digestive system than you? If you are worried about it, you can take some Imodium. It slows the digestive system. It might work. Good luck.

I take D3 in a softgel form, and these dissolve in the stomach, so I have never had an issue with them coming out in my bag.  

All three of my ostomy nurses told me to avoid extended release, soft gel, coated, and capsule medications and vitamins. They said to look for a good quality chewable (not a gummy) or non-coated tablet. I had issues after surgery with gabapentin causing a partial blockage and then coming out in my bag.

I've taken both forms and never had any issues with them not digesting or coming out in the pouch.  The only time I've had that happen was with Calcium Citrate.  

I think it's safe to say we ileostomates need to avoid all time-released medication. That said, gel caps are not all time-released. Some are rapid release, e.g., Ibuprofen gel caps. Though liquid and chewable are the safest routes, some medications in that form are more expensive or not covered by insurance and require compounding pharmacies. For tracking vitamin/mineral levels, the safest bet is to discuss with your physician and obtain blood levels. Also, a well-informed pharmacist can be a wealth of knowledge about absorption. When I discussed the use of Zyrtec with my pharmacist and my ileostomy, the first question was, “What is the condition of your small bowel?” She went on to tell me that Zyrtec was not considered extended release and was fine for me to take.

I was taking MetFORMIN ER and it was appearing in my bag. Due to this, I had to talk to my doctor about getting a different form. It seems anything that is in an extended release form has a very good chance of ending up in the bag since it is designed to be slowly absorbed as it passes through your system, and since things take a detour, the pill doesn't have time to fully absorb. But, if it is not in extended release form, I haven't had an issue.

Hi there! I have taken prescribed mega doses of Vitamin D every week, and it is in an oval softgel, and I have had no problem. However, the potassium I have to take are very large tablets, and those I have to crush or I cannot absorb them.

Hi, I have the illness, and when in the hospital, I was told I have a fast stomach and high illness. Yes, tablets were coming out before dissolving. Easy answer: just had all meds in a dissolving state, absolutely no problems, simples, and still do.

I take liquids…

Yeah, I could have, but because it's so deficient to get 500,000 units once weekly, the pharmacist said it would be a lot of liquid. If I were taking it daily to maintain levels, then I would for sure do liquids.

So far so good; that soft gel did its job as it never came out into the bag, so good to know soft gels are all good. Thanks, everyone, for sharing your experience. I love this website and group. Hope everyone has a great rest of their week.

I have had a lot of my pills, even capsules, not dissolve, so I take my tablets that do not have much coating, and the soft gel seems okay. The capsules on the other hand, I pull apart and put over applesauce and take it that way.

The Gab, I take pills now. They are 600 mg, which I take 300 mg twice a day, so with that, I cut them in half and they dissolve a lot better.

I take potassium also, and my doctor dropped the mg from 400 a day to 200 twice a day. Those come in capsules that pull apart and can be put over applesauce. I was told never to crush a pill, but doctors are different. The capsules cost more, so I use the GoodRx card to help pay for them.

I use a gel cap but I only take it 3-4 times per week because I noticed an odor that I thought I was getting from it. Has anyone else noticed an odor from D3?

What is sublingual?

under the tongue - aka quick dissolve

I take a powdered potassium that I can dissolve in water. It does have a unique taste, but I only use 4 oz of water to mix and drink it with.
I am not sure about the price.

My body seems to absorb this well.